In Puerto Princesa, reproductive health from the ground up

The RH storm has temporarily abated, but expect it to intensify again in the coming weeks or months. The bill’s long struggle to get passed into law may or may not end this year, and we will go through another dramatic round of debates, rallying, prayers and political pressure all over again. But let’s put that aside for now and see how others have addressed the immediate problems of maternal death, unwanted pregnancy and general dearth of sex education among poor women, in spite of the lack of help, and even outright obstruction, from the government. Like what we’ve learned from our weather-related tragedies, we can’t always rely on official institutions to solve our problems, especially when they’re often the cause of them. We rely on our own.

Roots of Health is a nonprofit organization based in Puerto Princesa, Palawan that provides education and reproductive health services to the women and girls of the community. Run by a balikbayan, Ami Evangelista, and her South African husband Marcus Swanepoel, the group teaches high school and college students lessons on topics that range from self-esteem to sexually transmitted diseases. They were in Manila, incidentally right before the vote to end the debates in Congress, to introduce Roots of Health and share what they’ve been doing down in Palawan. Ami, who is pregnant with their second child, sat down with the Philippine STAR and talked about sex… education.

YSTYLE: What kind of education does Roots of Health provide?

AMI EVANGELISTA: We have two very distinct forms of education, the type we give to women in the communities, and the schools. For the women, it has to adult learner-focused, assuming there’s not a great deal of knowledge already. Our clients finish only up to second or third grade, so it’s not too data-focused. We try to make it fun and engaging, not overwhelming.

In the schools, we have to account for what is age appropriate: what can we say to 13 and 14 year olds vs. 17 and 18 year olds, keeping a positive message. If you just say sex is bad, they’re not going to talk to you. We keep it positive, still trying to impart that they have to think carefully before they act and focus on what they their goals and dreams are. 

Do you find that high school is a little late to begin sex ed?

Actually it can be. Last year we were invited to teach with Grades 5 and 6. Because of age-appropriateness, we focused not on sex but on puberty and what it means. When ROH began we started with fourth-year students, but that was when a lot of the pregnancies happen. So now we really want to work across the board as quickly as possible, try to get the first and second year students before they’ve actually initiated first sex so that at least if and when they do have sex, they’re doing it safely.

Do you distribute contraception?

In our community sites we give them for free, to anybody who asks. We do not distribute contraceptives at schools. Some schools specifically said it was not allowed and some haven’t, but we just decided not to because it would cause too much friction. I can understand how parents would be upset if their 14 year old is coming home with condoms or birth control. In high school we teach the basic info and tell them if they want to avail of our health services to come to our office. If they come to our office, it’s off-campus, they come of their own volition and can have confidential conversations with our nurses and midwives, figure out what their situation is, and if they want to use contraceptives, figure out what kind is the best for them.

Are they still embarrassed to seek your help?

High schoolers tend not to come, and it’s really hard to change behaviors. Of course it’s terribly depressing when you teach a group of students and find out a few months later one of them is pregnant. But I think it’s too much trouble for them and they’re embarrassed; we have yet to figure out a way to get around that. It’s tricky with kids, if they trust us we don’t want to betray that trust; at the same time they are minors. College kids who are of age, a lot of them do come to our office and ask us for contraception so we’re very happy to help them.

How do you measure effectiveness?

That’s actually one of the things that are really hard to measure. How do you measure a pregnancy that didn’t happen? It’s especially hard in Palawan because there aren’t a lot of data on things like this, even census data. Even schools where so many girls drop out, most of the schools don’t list the reason why, or even if they have dropped out. So it’s difficult to measure the unplanned pregnancy. We pick data that we can measure, one of the things is drop out rates. Of course, there will be other reasons for dropping out, but over the years we can see in the schools we work in, if the drop out rates have shifted a little bit, we can’t say its all us, but we can say some of that is due to the education we’re giving.

We track attendance. We have a cell phone hotline, so we track what kinds of questions they have and what kind of information they’re looking for. We have a lot of anecdotal data, of just students telling us what a difference it’s made to them to have a reliable and trusted source, where before they had to rely on their friends. A lot of people rely on porn for their sex ed, because they’re not getting it from parents or school.

A woman for others: Ami Evangelista Swanepoel, co-founder and executive director of Roots of Health

How do the men of the community fit into this?

When we started working in the community sites, the men were a little suspicious of us at first. We specifically target the most underserved communities. For one thing they’re not very used to having someone come in and offer services. They were probably afraid we were going to tell the women to stop having sex with them. Over the weeks and months, they saw that we were really focusing on the health of their wives. And we have a lot of outreach programs for kids, so they could see that their whole family is benefiting from the programming of this organization. They’ve become friendlier, and help us set up our equipment and materials. Every so often we have special events that include the men. Some of the men, unfortunately, are out of work and disempowered and spend most of the day drunk, so they’re not necessarily unsupportive but just panggulo.

What do you do if someone comes seeking an abortion?

We comply fully with Philippine law: we don’t support it, we don’t counsel it, we don’t assist in any way. Whenever someone questions me about our work, “Oh, you’re pro-RH, does that mean you’re for abortion?” I always say we’re totally against it, but what we try to do is to help prevent an unplanned pregnancy from happening in the first place, minimizing the need for abortion. We believe in educating women and girls about their bodies and how pregnancy happens, so they don’t have to face that situation. If somebody did come to us and tell us she was pregnant, we would try to give her the best prenatal care she can have.

What are your thoughts on the RH Bill?

We’re doing our work because the government isn’t providing the basic services that Filipinos deserve, and until they do, we’re just going to keep doing it. With the RH bill and policy debates, it’s all so politicized, but really, on the ground it doesn’t come into things at all. Most of our clients are so poor and live hand to mouth, they don’t watch politics, don’t follow debates, they’re just trying to figure out where they’re getting their next meal. Of course we support the bill. Any non-profit, your absolute success would be if you can shut down and nobody needs your help anymore. I would love for the day to come when I can say, “I’m gonna shut down Roots of Health because there are no more health problems anymore among women in the Philippines.” If the RH bill were to pass, we would be in a really good position to help government workers with how to deliver the services. We’ve been very collaborative with the LGUs who recognize we are a big help, since they’re so understaffed and overworked, like one barangay health worker caring for 12,000 households. If the bill passes, we will keep partnering with them until they’re fully ready to be providing these services.

* * *

Help keep Roots of Health sustainable. Find out more at rootsofhealth.org.